Individual
KIMBERLY DAWN SHELBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MCD, CCC-SLP
Contact information
Practice address
105 N OAK ST, BROOKLAND, AR 72417
(870) 935-7809
Mailing address
105 N OAK ST, BROOKLAND, AR 72417-8831
(501) 291-7222
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP663
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
121751721
—
AR
Enumeration date
05/04/2007
Last updated
07/05/2018
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